Depression Of Platelet Count Research Articles

Clinical significance of right hepatectomy along the main portal fissure on donors in living donor liver transplantation

There might be discordance between inter-lobar borders of the main portal fissure (MPF) using the middle hepatic vein (MHV) and of the portal segmentation. Forty-five living donors who underwent right hepatectomy for the adult recipients from 2007 to 2011 in a tertiary hospital were retrospectively analyzed. The donors were classified into conventional right hepatectomy along the MPF (cRL group, n = 26) and modified right hepatectomy along right-side shifted transection plane from the MPF (mRL group, n = 19). The cRL donors had higher postoperative peak level of INR (1.84 vs. 1.62; P = 0.022), and bilirubin (3.37 mg/dl vs. 2.74 mg/dl; P = 0.065) than the mRL donors. cRL donors experienced greater depression of platelet count (144 per nL vs. 168 per nL; P = 0.042) and enlargement of splenic volume (52% vs. 37%; P = 0.025) than mRL donors for 7 days after hepatectomy. The regeneration of the left lateral sector was more accelerated in the cRL donors than the mRL donors for postoperative 3 months (148% vs. 84%; P = 0.015). There were no differences in the post-transplant graft function, incidence of complications, and graft survival rates between the two groups of recipients (P > 0.05). This study suggests that the conventional right hepatectomy along the MHV might increase donor risk by reducing parenchymal liver volume of the segment IV.

Depression of platelet counts in apparently healthy children with asymptomatic malaria infection in a Nigerian metropolitan city

Asymptomatic malaria infection is a common feature of malaria endemic regions in the tropics. In this prospective cross sectional survey, involving 240 children aged 1 to 8 years (Boys = 117, Girls = 123; Ratio 1:1.05), the median platelet count was 115 × 109/L (IQR 97.5–190). Thirty-three out of 240 (13.75%) of the children had thrombocytopenia (platelet count < 100 × 109/L). Malaria parasite was found to exert significant reduction in platelet count. This reduction was more pronounced in children under 5 years and also at higher parasite counts. An inverse relationship was established between parasite density and platelet count (y = −0.017x + 96.2, r = −0.2). Thrombocytopenia is not only a feature of acute malaria infection but also that of asymptomatic malaria infection in the tropics and might be a useful indicator of malaria in children.

Successful treatment of severe refractory idiopathic thrombocytopenic purpura with liposomal doxorubicin

Idiopathic thrombocytopenic purpura (ITP) is refractory to initial treatment (steroids and splenectomy) in 25 to 30% of patients. These patients have a significant risk of fatal hemorrhage. Two patients with ITP refractory to multiple interventions and severe depression of platelet counts responded to treatment with liposomal doxorubicin with a return of platelet counts to normal. The drug is easily administered and was well tolerated. Use of this drug in refractory ITP merits further study.

Epidural Hematoma After Epidural Anesthesia in a Patient with Hepatic Cirrhosis

Epidural Hematoma After Epidural Anesthesia in a Patient with Hepatic Cirrhosis

Haematological toxicity of carboplatin and cisplatin combined with whole body hyperthermia in rats

Acute haematological toxicity induced by cis-diammine-1,1-cyclobutane dicarboxylate platinum (II) (carboplatin) and cis-diamminedichloroplatinum (II) (cisplatin) in combination with whole body hyperthermia (WBH) (2 h at 41.5 degrees C) was examined using a F344 rat model. The thermal enhancement ratios (TERs) of drug-mediated thrombocytopenia, anaemia and leukopenia were determined from the dose-response curves of the nadir values of the peripheral platelet, RBC and WBC counts. Carboplatin produced profound depression of platelet counts which was over three-fold greater than cisplatin (14% vs 51% of the control), while the decrease in WBC and RBC counts induced by carboplatin did not differ significantly from those observed with cisplatin. These carboplatin or cisplatin-mediated haematological toxicities were significantly enhanced by WBH. The depth of decrease in platelet, RBC and WBC counts induced by the maximum tolerated dose (MTD) of carboplatin (30 mg kg-1) combined with WBH was identical to that induced by the MTD of carboplatin (70 mg kg-1) alone. The TERs of carboplatin-mediated thrombocytopenia, anaemia and leukopenia were 2.0, 2.8 and 1.9, respectively. The thermal enhancement of cisplatin mediated haematological toxicity was similar to that of carboplatin, with TERs of 1.8 for thrombocytopenia, 2.4 for anaemia and 1.9 for leukopenia. These data, demonstrating thermal enhancement of cisplatin or carboplatin-mediated haematological toxicity, must be taken into account in the clinical application of the combination therapy of platinum and WBH.

Hematologic effects of recombinant human granulocyte colony-stimulating factor in patients with malignancy

The effect of recombinant human granulocyte colony-stimulating factor (G-CSF) on hematologic parameters was evaluated in a phase I clinical study in 18 patients with advanced malignancy. G-CSF was administered once daily as a 30-minute infusion for 14 days; three patients each were treated at increasing dose levels of 1, 3, 10, 30, and 60 micrograms kg-1 day-1. A transient decrease in neutrophil and monocyte counts was observed immediately after the G-CSF infusion, followed by a dose-dependent increase of up to 15-fold. G-CSF-induced neutrophils exhibited an increased O2- radical production, and serum levels of enzymes related to granulocyte turnover, including lysozyme and elastase, were markedly elevated during therapy. A dose-dependent depression of platelet counts occurred in the second third of the treatment course, followed by a spontaneous recovery despite continuing therapy. G-CSF was well-tolerated; minor to moderate bone pain was the most common side effect. The primary course of the malignant diseases studied was not significantly altered. G-CSF appears to be an appropriate means to selectively increase the number of functionally competent polymorphonuclear phagocytes.

Hematologic Effects of Recombinant Human Granulocyte Colony-Stimulating Factor in Patients With Malignancy

The effect of recombinant human granulocyte colony-stimulating factor (G-CSF) on hematologic parameters was evaluated in a phase I clinical study in 18 patients with advanced malignancy. G-CSF was administered once daily as a 30-minute infusion for 14 days; three patients each were treated at increasing dose levels of 1, 3, 10, 30, and 60 micrograms kg-1 day-1. A transient decrease in neutrophil and monocyte counts was observed immediately after the G-CSF infusion, followed by a dose-dependent increase of up to 15-fold. G-CSF-induced neutrophils exhibited an increased O2- radical production, and serum levels of enzymes related to granulocyte turnover, including lysozyme and elastase, were markedly elevated during therapy. A dose-dependent depression of platelet counts occurred in the second third of the treatment course, followed by a spontaneous recovery despite continuing therapy. G-CSF was well-tolerated; minor to moderate bone pain was the most common side effect. The primary course of the malignant diseases studied was not significantly altered. G-CSF appears to be an appropriate means to selectively increase the number of functionally competent polymorphonuclear phagocytes.

The effect of splenectomy on the haematological response to radiotherapy in Hodgkin's disease.

Summary. Splenectomy performed as part of the initial treatment of Hodgkin's disease resulted in less depression of platelet count during radiotherapy than that seen in patients who had radiotherapy followed by splenectomy. The difference was Significant whether the removed spleen was grossly enlarged or not. There was no significant difference in white cell count in the two groups, nor was the duration of radiotherapy longer in the patients who had splenectomy after radiotherapy. We concluded that splencetomy as part of the initial treatment does not confer any worthwhile protection to the bone marrow during mantle radiotherapy.

Subclinical coagulopathy following amnioinfusion with hypertonic saline

Previously reported blood coagulation changes in unselected cases undergoing hypertonic saline amnioinfusion for second-trimester abortion were reviewed and compared with the authors' experience in 22 cases. The majority of cases studied developed laboratory evidence of coagulopathy within hours following infusion although no cases developed bleeding problems. Nearly all studies demonstrated an early postinfusion appearance of fibrin monomer complexes along with depression of platelet count, fibrinogen, and Factor VIII. Fibrin and fibrinogen degradation products also appeared early, and two studies demonstrated a significant drop in plasminogen. Only the author's work demonstrated a significant shortening of euglobulin clot lysis time indicating possible systemic activation of fibrinolysis. All factors exhibited a tendency to return toward normal by 24 to 48 hours after infusion, sometimes even before abortion was completed. Plasma fibrinogen and activated partial thromboplastin times are recommended in evaluating heavy uterine hemorrhage following saline amnioinfusion.